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Which instruction has priority when teaching a patient taking clozapine (Clozaril)?
- A. Avoid unprotected sex.
- B. Report sore throat and fever immediately.
- C. Reduce foods high in polyunsaturated fats.
- D. Use over-the-counter preparations for rashes.
Correct Answer: B
Rationale: The correct answer is B: Report sore throat and fever immediately. This is because clozapine can cause a serious condition called agranulocytosis, which is characterized by a dangerously low white blood cell count. Sore throat and fever can be early signs of this condition, so it is crucial to report them immediately to prevent serious complications.
Avoiding unprotected sex (choice A) is important for overall health but is not directly related to clozapine use. Reducing foods high in polyunsaturated fats (choice C) is not a priority as it does not impact the safety or effectiveness of clozapine. Using over-the-counter preparations for rashes (choice D) is not advised as rashes can be a side effect of clozapine, and professional medical advice should be sought.
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A person suffering from hypoactive sexual desire disorder has:
- A. Too little interest in sex
- B. Too much interest in sex
- C. An obsessive need to expose their genitals in public
- D. A desire to witness suffering in other people
Correct Answer: A
Rationale: Hypoactive sexual desire disorder is defined by a persistent lack of sexual interest or desire.
A woman tells the nurse that her husband abuses her most often when he is intoxicated, just as his father had beaten him and his mother. The woman is aware of the location of a safe house and has considered leaving home with her two children, but she cites being brought up to believe 'you keep quiet and stay together, no matter what happens.' She states the husband is always apologetic and remorseful after an incident. What evidence exists that the husband is at risk of becoming a perpetrator of physical abuse? He:
- A. is unable to make lasting behavioral changes.
- B. was an abused child.
- C. is without a job.
- D. experiences remorse.
Correct Answer: B
Rationale: The correct answer is B because the husband's history of being abused as a child increases his risk of becoming a perpetrator of physical abuse. Research shows that individuals who have been abused are more likely to perpetrate abuse themselves. This is due to a cycle of violence where behaviors learned in childhood are repeated in adulthood. In this case, the husband's abusive behavior towards his wife mirrors his own upbringing where his father abused his mother. This pattern suggests that the husband may continue the cycle of abuse.
Choice A (is unable to make lasting behavioral changes) is incorrect because it does not directly correlate with the risk of becoming a perpetrator of physical abuse. Choice C (is without a job) is also incorrect as employment status does not necessarily indicate a propensity for abuse. Choice D (experiences remorse) is incorrect as feeling remorse after abusive incidents does not negate the risk of becoming a perpetrator of physical abuse.
A nurse is caring for a patient with bulimia nervosa. The nurse should monitor for which of the following complications?
- A. Nutritional deficiency and dehydration.
- B. Respiratory failure and aspiration pneumonia.
- C. Peripheral edema and hyperkalemia.
- D. Mental confusion and decreased blood pressure.
Correct Answer: A
Rationale: The correct answer is A: Nutritional deficiency and dehydration. In bulimia nervosa, recurrent episodes of binge eating followed by purging can lead to electrolyte imbalances, dehydration, and malnutrition. Monitoring for nutritional deficiencies and dehydration is crucial in managing patients with bulimia nervosa.
Explanation for why other choices are incorrect:
B: Respiratory failure and aspiration pneumonia - Although purging behaviors can increase the risk of aspiration pneumonia, it is not as common as nutritional deficiencies and dehydration in patients with bulimia nervosa.
C: Peripheral edema and hyperkalemia - These complications are not typically associated with bulimia nervosa.
D: Mental confusion and decreased blood pressure - While electrolyte imbalances can lead to mental confusion, these specific complications are not as common as nutritional deficiencies and dehydration in patients with bulimia nervosa.
What is the most effective strategy for preventing relapse in patients with anorexia nervosa?
- A. Providing a strict, rigid meal plan that the patient must follow.
- B. Offering frequent, supportive counseling to address underlying issues.
- C. Encouraging the patient to self-monitor their food intake only.
- D. Reassuring the patient that their weight will stabilize without further intervention.
Correct Answer: B
Rationale: The correct answer is B because offering frequent, supportive counseling to address underlying issues is the most effective strategy for preventing relapse in patients with anorexia nervosa. Counseling helps patients explore and work through the root causes of their disorder, such as body image issues, low self-esteem, or past trauma. It also provides ongoing support and guidance in developing healthy coping mechanisms and behaviors.
Choice A is incorrect because providing a strict, rigid meal plan can exacerbate feelings of control and restriction, which are common triggers for relapse in individuals with anorexia nervosa.
Choice C is incorrect as solely focusing on self-monitoring food intake may not address the psychological and emotional factors contributing to the disorder, which are crucial for long-term recovery.
Choice D is incorrect because reassuring the patient that their weight will stabilize without further intervention ignores the complexities of anorexia nervosa and does not address the underlying issues that need to be resolved for sustained recovery.
What is the correct assessment for a patient with bulimia nervosa who frequently engages in purging behaviors?
- A. Observe for parotid gland enlargement and dehydration.
- B. Assess for fluid retention and leg swelling.
- C. Perform regular weight checks to assess for weight loss.
- D. Evaluate for signs of hyperactivity and poor sleep.
Correct Answer: A
Rationale: The correct assessment for a patient with bulimia nervosa who frequently engages in purging behaviors is to observe for parotid gland enlargement and dehydration. Parotid gland enlargement is a common physical manifestation due to repeated vomiting, and dehydration can result from purging behaviors. This assessment is crucial in monitoring the patient's physical health and identifying potential complications. Assessing for fluid retention and leg swelling (Choice B) is more typical in conditions like heart failure. Performing weight checks (Choice C) may not accurately reflect the patient's health status due to fluid shifts. Evaluating for signs of hyperactivity and poor sleep (Choice D) are not directly related to the immediate physical consequences of purging behaviors.